Antibiotic therapy and leukocytospermia: a prospective, randomized, controlled study
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E H Yanushpolsky1, J A Politch, J A Hill
1Department of Obstetrics, Gynecology, and Reproductive Biology, Fearing Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Objective:
To determine the efficacy of common antibiotic therapies for treatment of leukocytospermia of unknown etiology.
Design:
Prospective, randomized, controlled clinical study.
Setting:
Fertility and Endocrinology Unit at Brigham and Women's Hospital, Boston, Massachusetts.
Patients:
One thousand seven hundred ten male partners in infertile couples attending the Fertility and Endocrinology Unit.
Interventions:
Concentrations of seminal peroxidase-positive granulocytes were determined during all routine semen analyses performed over a 30-month period. Of 119 men found to have leukocytospermia (> 10(6) granulocytes/mL semen) on first visit, 54 agreed to be randomized into one of three groups, and 41 patients completed the study. Group I (n = 13) and their wives received a 14-day course of oral doxycycline, 100 mg twice per day. Group II (n = 11) and their wives received a 14-day course of oral trimethoprim 160 mg-sulfamethoxazole 800 mg twice per day. Group III (n = 17) and their wives received no therapy. Four weeks after randomization, repeat semen analyses and granulocyte quantitations were done.
Results:
Neither of the antibiotic regimens resulted in a significantly higher rate of resolution of leukocytospermia over that seen in the control group.
Conclusions:
There is a high rate of spontaneous resolution of leukocytospermia after one positive test. Antibiotics are no more beneficial than no therapy for treatment of this condition.